Sepsis – Common Symptoms

Sepsis manifests differently in adults, children, and babies, making it essential to understand the distinct symptoms and warning signs for each group. In adults, the common symptoms often begin with a high fever, although in some cases, the body temperature may drop below normal. People often report chills and uncontrollable shivering, paired with a rapid heart rate and quickened breathing.

As the condition progresses, confusion or disorientation may develop, accompanied by extreme fatigue or a sense of weakness. Many adults experience pale, mottled, or clammy skin, and they may produce less urine, which can signal early organ involvement. While these symptoms might resemble other illnesses, the combination of rapid deterioration and the body’s systemic response is a red flag that requires immediate attention.

The UK Sepsis Trust have created the below acronym to help remember the common signs and symptoms of Sepsis in adults:

Slurred speech or confusion
Extreme shivering or muscle pain
Passing no urine (in a day)
Severe breathlessness
It feels like you’re going to die
Skin mottled or discoloured

For children, the signs of sepsis can vary significantly depending on age and overall health. A child may present with persistent high fever or, less commonly, a dangerously low temperature. They might appear unusually drowsy or difficult to wake, and their breathing could become fast or laboured. Unlike adults, children might exhibit a more visible decline in activity levels, appearing lethargic or uninterested in their surroundings. Their skin may take on a pale or bluish appearance, and they might refuse food altogether. Some children may also have a rash that doesn’t fade when pressed, similar to meningitis, a critical sign often associated with severe infections.

In babies, the symptoms of sepsis are often subtle but equally dangerous. A baby might become unusually quiet or irritable, a cry which is very different to their usual cry and may show signs of distress when handled. They could struggle to feed, refuse milk, or vomit. Their body temperature might either spike or drop, with low temperatures being a particular concern in very young infants. Breathing difficulties, such as rapid or irregular breathing, can also occur. Other warning signs include a swollen abdomen, jaundice, or floppy limbs. In severe cases, babies may have seizures or lose consciousness.

It is important to note that not all individuals with sepsis will display every symptom. Age plays a significant role in how sepsis presents. Older adults may not develop the fever, which is a hallmark symptom in younger, healthier individuals, and instead may primarily exhibit confusion or lethargy. Infants, on the other hand, may show only vague signs such as the irritability, poor feeding, or pale complexion. Additionally, people with compromised immune systems, such as those undergoing chemotherapy or living with chronic illnesses, may have a muted immune response, which can result in less obvious symptoms like a lack of fever. Conversely, individuals with autoimmune conditions might show heightened inflammatory responses, even if the infection itself is mild.

The origin of the infection also influences symptom presentation. For instance, sepsis that begins with a urinary tract infection might initially cause lower abdominal pain or frequent urination, while sepsis stemming from a lung infection may feature respiratory symptoms such as coughing or wheezing. The stage at which sepsis is detected can further alter its presentation; early signs may be subtle and easily overlooked, while later stages are more dramatic, involving significant organ dysfunction.

Chronic health conditions can further complicate the clinical picture. For example, a person with diabetes might attribute unusual fatigue or excessive thirst to their underlying condition rather than recognising it as a symptom of sepsis. Similarly, shortness of breath in someone with heart disease might initially be dismissed as a cardiac issue rather than being linked to a systemic infection.

Early recognition is critical. Prompt medical intervention, including antibiotics and supportive care, can significantly improve survival rates and reduce the risk of long-term complications. Recognising subtle signs and maintaining awareness of sepsis as a potential diagnosis can make the difference between recovery and critical illness.